Jennifer Anne Wagner, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

11315 Issued in FL

Practice address

13801 Walsingham Rd # a-164
Largo, FL 33774-3237

Phone

(206) 226-1664

NPI assigned

Oct 13, 2022

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, FL, SC, TX, NC, VA, MI7 enrollments

Enrollment records 7

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19050/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Woman Care, LLC

  dba Alline

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1386823243
  Medicare reassignment NPD
• Genesis OB GYN PLLC

  • Obstetrics & Gynecology Physician
  • Tucson, AZ
  • NPI 1992994214
  Medicare reassignment NPD
• Mid-Atlantic Womens Care PLC

  • Obstetrics & Gynecology Physician
  • Virginia Beach, VA
  • NPI 1699365072
  Medicare reassignment NPD
• Unified Women's Healthcare of Texas PLLC

  • Obstetrics & Gynecology Physician
  • Addison, TX
  • NPI 1952703373
  Medicare reassignment NPD
• Uwh of Michigan PLC

  • Obstetrics & Gynecology Physician
  • East Lansing, MI
  • NPI 1982352357
  Medicare reassignment NPD
• Uwh of the Carolinas, PLLC

  • Obstetrics & Gynecology Physician
  • Morrisville, NC
  • NPI 1639506470

  SC

  Medicare reassignment NPD
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)
• Genneve Medical P.C.

  • Gynecology Physician
  • Kirkland, WA
  • NPI 1336888163
  NPD (past)
• Metro Partners in Womens Health, PC

  dba Metro Partners in Women's Health

  • Obstetrics & Gynecology Physician
  • Novi, MI
  • NPI 1083601082
  NPD (past)
• Mid-Atlantic Womens Care PLC

  dba Complete Womens Care

  • Obstetrics & Gynecology Physician
  • Virginia Beach, VA
  • NPI 1851339246
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1336865104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14887 SEMINOLE TRL",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337761081",
            "telephone_number": "206-226-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 WALSINGHAM RD # A-164",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743237",
            "telephone_number": "206-226-1664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 4th Avenue Cir E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342085623",
            "country_code": "US",
            "telephone_number": "206-895-4292",
            "fax_number": "833-973-4033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 E River Rd Unit 201",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857045853",
            "country_code": "US",
            "telephone_number": "206-895-4292",
            "fax_number": "833-973-4037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Perimeter Park Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Morrisville",
            "state": "NC",
            "postal_code": "275609714",
            "country_code": "US",
            "telephone_number": "206-895-4292",
            "fax_number": "833-973-4034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6100 Harris Pkwy Ste 140",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761324130",
            "country_code": "US",
            "telephone_number": "206-895-4292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "828 Healthy Way Ste 330",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234627959",
            "country_code": "US",
            "telephone_number": "206-895-4292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT90667",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L008231",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "11315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Vizzi, M.D.
• VMD Primary Providers Central Florida PLLC
• Anca Voinov, MD
• Kelly Briana Volland
• Anthony Vu, O.D.
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5831)
• Wal-Mart Stores East LP (WalMart Pharmacy 10-4141)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1712)
• Nathan Keith Waldrep, MD
• Walgreen Co (Walgreens Specialty Pharmacy #13630)

• Registered Dietitian in Largo, FL
• Providers in Largo, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.